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Trial registered on ANZCTR
Registration number
ACTRN12617000327381
Ethics application status
Approved
Date submitted
23/02/2017
Date registered
1/03/2017
Date last updated
21/10/2021
Date data sharing statement initially provided
21/10/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Cost-effectiveness of Tai Chi for improving balance and falls prevention in cerebellar ataxia
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Scientific title
Cost effectiveness of Tai Chi for improving balance and falls prevention in cerebellar ataxia: An economic evaluation alongside a randomized controlled trial
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Secondary ID [1]
291265
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Nil
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Universal Trial Number (UTN)
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Trial acronym
CAATs (Cerebellar Ataxia Assessment and Treatment Trials) project
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cerebellar ataxia
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Condition category
Condition code
Neurological
301806
301806
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Group 1 (intervention group)- Tai Chi ; Group 2 control group
Participants in group 1 will undergo 12 weeks of Tai Chi training at the Department of Rehabilitation Sciences (RS), Hong Kong Polytechnic University (HKPolyU), three times a week and each session lasting for 60 minutes. A Tai Chi Master will be employed to conduct the Tai Chi sessions. The 8-form Tai Chi routine will be delivered to the participants by the Tai Chi master. This 8-form Tai Chi has been derived from Yang’s style of the traditional long-form Tai-Chi routine. The 8-form Tai Chi is specifically designed for people having difficulty in standing while practicing Tai-Chi. The participants will be encouraged to continue Tai Chi practice following the 12 weeks of training.
The participants of the usual care control group will receive one session of advice on falls prevention lasting for 30 minutes. No other intervention will be offered. The participants of the usual care control group are free to continue their routine activities over the study period. Participants of both the groups will be instructed not to register for any new exercise programs over the study period.
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Intervention code [1]
297273
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Rehabilitation
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Comparator / control treatment
The participants of the usual care control group will receive one session of advice on falls prevention lasting for 30 minutes. No other intervention will be offered. The participants of the usual care control group are free to continue their routine activities over the study period. Participants of all three groups will be instructed not to register for any new exercise programs over the study period.
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Control group
Active
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Outcomes
Primary outcome [1]
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Berg Balance Scale (BBS)
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Assessment method [1]
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Timepoint [1]
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Week 0, Week 12, 6 months and 12 months
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Primary outcome [2]
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Gait, stance and sit sub-components of the Scale for the Assessment and Rating of Ataxia (SARAbal)
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Assessment method [2]
301251
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Timepoint [2]
301251
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week 0, week 12, 6 months and 12 months
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Primary outcome [3]
301254
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EuroQol 5 dimension 5 level (EQ5D 5L)
quality-adjusted life-year (QALY) gain or loss will be estimated using EuroQol 5 dimension 5 level (EQ5D 5L) questionnaire. The EQ 5D 5L questionnaire includes 5 questions addressing 5 domains (mobility, self-care, usual activities, pain and anxiety), each domain scored based on a five level index. Level 1 implies “no problem” and 5 “extreme problem”. This measure also has a visual analogue scale to rate the overall health status ranging between 0 and100, where 0 implies to the worst health one can imagine and 100 being the best health status. Permission to use the HK version of the EQ 5D 5L has been obtained and it will be used.
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Assessment method [3]
301254
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Timepoint [3]
301254
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Week 0, week 12, 6 months and 12 months
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Secondary outcome [1]
332109
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Sensory Organization Test (SOT)
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Assessment method [1]
332109
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Timepoint [1]
332109
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week 0, week 12, 6 months and 12 months
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Secondary outcome [2]
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Scale for the Assessment and Rating of Ataxia (SARA)
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Assessment method [2]
332110
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Timepoint [2]
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week, 0, week 12, 6 months and 12 months
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Secondary outcome [3]
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Falls history
Assessing number of falls: Number of falls encountered following intervention will be used to report the frequency of falls. We operationally define fall as an event when the person ends up on the ground or other surfaces due to a trip or any other unintentional activity and a near fall as an unexpected loss of balance that did not result in complete loss of upright standing. The participants will be instructed to record the number of falls and near falls over the follow-up period using the cost and falls dairy.
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Assessment method [3]
332111
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Timepoint [3]
332111
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week 12, 6 months and 12 months
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Eligibility
Key inclusion criteria
(1) patients with a definite diagnosis of CA due to any underlying cause, (2) not on formal exercise programme, (3) have had at least one fall over the past six months and (4) walk at least 10 metres with or without the support of a walking assistive device.
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Minimum age
18
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(1) previous history of stroke or any other neurological disorders, (2) severe cardio-vascular diseases that might prevent them from participating in exercise, (3) severe degenerative joint diseases causing excessive pain and discomfort, and (4) severe cognitive and visual impairments
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
An administrator who is not a part of the research team will randomize participants to groups 1or 2 using pre-determined block randomization
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A computer generated random numbers list will be created by the statistician and each participant will receive a unique number for identification. In order to ensure treatment allocation concealment, the group allocation will not be revealed to the principal investigator.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
The Research Assistant and the Tai Chi master cannot be blinded to randomization groups because the exercise intervention will be conducted by both of them. The nature of the intervention is such that participant blinding is also impossible.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Data analysis will be performed using SPSS, version 22.0. Analysis will be conducted blinded for group allocation. Demographic data will be reported as mean and standard deviation for continuous variables and number and percentage for categorical variables. Mean baseline scores between the groups will be compared using independent t-tests. Analysis of covariance (ANCOVA) will be used to compare the clinical outcome measures at 95% confidence interval. ANCOVA has the advantage of comparing clinical outcome measures having significant difference in the baseline values and in addition it improves the statistical power and accuracy even when the baseline differences are small and insignificant.
Cost effectiveness analysis will be performed according to intention-to-treat principle. The EQ 5D 5L (HK version) will be used to estimate the quality-adjusted life-year (QALY) gain or loss over the follow-up period. The mean QALY gain or loss will be calculated for each group at 6 and 12 months.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
24/04/2017
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Actual
30/06/2017
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Date of last participant enrolment
Anticipated
31/10/2017
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Actual
31/10/2017
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Date of last data collection
Anticipated
31/10/2018
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Actual
31/10/2018
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Sample size
Target
40
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Accrual to date
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Final
24
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Recruitment outside Australia
Country [1]
8688
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Hong Kong
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State/province [1]
8688
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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The Hong Kong Polytechnic University
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Address [1]
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The Hong Kong Polytechnic University,
Hung Hom,
Kowloon,
Hong Kong
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Country [1]
295720
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Hong Kong
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Primary sponsor type
Individual
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Name
Dr Stanley John Winser
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Address
Hong Kong Polytechnic University
No 1, Chatham Road North,
King's Park,
Kowloon,
Hong Kong.
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Country
Hong Kong
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Secondary sponsor category [1]
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None
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Name [1]
294568
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Address [1]
294568
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Country [1]
294568
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Other collaborator category [1]
279443
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Individual
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Name [1]
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Author withdrew form the study
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Address [1]
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Dr Haxby Abbott,
Research Associate Professor,
Dunedin public hospital,
201 Great King St,
Orthopaedic Surgery section,
University of Otago,
Dunedin,
New Zealand
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Country [1]
279443
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297024
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Human Subjects Ethics application review System’, HK
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Ethics committee address [1]
297024
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Human Subjects Ethics application review System, The Hong Kong Polytechnic University, No 1, Chatham Road North, King's Park, Kowloon,
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Ethics committee country [1]
297024
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Hong Kong
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Date submitted for ethics approval [1]
297024
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03/04/2017
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Approval date [1]
297024
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30/06/2017
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Ethics approval number [1]
297024
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HSEARS20170519004
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Summary
Brief summary
Tai Chi is a form of martial art that is practiced for defense and health benefits. The health benefits of Tai Chi are well documented, which includes improved fitness, muscle strength and reduced falls risk. Convincing evidence also supports the use of Tai Chi in improving balance control. However, most of these studies are restricted to elderly people. Among neurological disorders, Tai Chi has been found to improve balance and reduce falls in Parkinson’s disease and stroke and improve balance in multiple sclerosis and spinal cord injury. To our knowledge, no research has examined the benefits of Tai Chi in health conditions resulting in cerebellar ataxia. This study will be conducted in 2 phases. In phase 1, the short-term and long-term treatment effectiveness of Tai Chi will be tested using a RCT. Phase 2 will be conducted alongside the RCT as an economic evaluation that will explore the cost effectiveness of Tai Chi, relative to usual care.. This economic evaluation will be conducted in a societal perspective having follow-ups at 6 and 12 months.
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Trial website
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Trial related presentations / publications
Nil
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Public notes
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Contacts
Principal investigator
Name
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Dr Stanley John Winser
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Address
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Room ST 514,
Department of Rehabilitation Sciences,
The Hong Kong Polytechnic University,
No 1, Chatham Rd N, King's Park,
Hong Kong
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Country
72746
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Hong Kong
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Phone
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+852 27666746
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Fax
72746
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Email
72746
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[email protected]
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Contact person for public queries
Name
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Stanley john WInser
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Address
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Room ST 514,
Department of Rehabilitation Sciences,
The Hong Kong Polytechnic University,
No 1, Chatham Rd N, King's Park,
Hong Kong
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Country
72747
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Hong Kong
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Phone
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+852 27666746
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Stanley John Wisner
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Address
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Room ST 514,
Department of Rehabilitation Sciences,
The Hong Kong Polytechnic University,
No 1, Chatham Rd N, King's Park,
Hong Kong
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Country
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Hong Kong
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Phone
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+852 27666746
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Fax
72748
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Email
72748
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
We do not have data from individual participants that could be shared.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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